Objective To study the clinical value of combined detection of D-dimer,PT,FIB and Cyc-C in the patients with nephrotic syndrome(NS) complicating thromboembolism.Methods Sixty-five patients with clinically diagnosed NS(observation group) in the Huangshi Municipal Central Hospital from April 2013 to March 2016 were selected and divided into the non-thromboembolism group(group A,45 cases) and thromboembolism group(group B,20 cases).Contemporaneous 43 individuals undergoing physical examination served as the control group(group C).The levels of Cys-C and 24 h urine protein were tested by the electrochemical luminescence method;meanwhile PT,FIB and D-dimmer levels were detected by the nephelometry method.Their changes in the patients with NS complicating thromboembolism were observed.Results The levels of Cys-C,24 h urine protein and D-dimer in the observation group were significantly higher than those in the control group (P＜0.01).The difference of PT and FIB levels were not statistically significant(P＞0.05);the D-dimer and Cys-C levels in the observation B group was significantly higher than that in the observation A group(P＜0.05),moreover the D-dimer level was positively correlated with Cys-C.Conclusion D-dimer and Cys-C can be used as the predictive factors of thromboembolism occurrence in NS patients.

Objective AccordingtothestandardofCochranehandbook (manual)weperformed statistics,analysis,andappraisalonatotalof 2 0volumes 15 8issuesofChineseJournalofRadiologyfrom 1980to 1999.Methods 2 0volumes 15 8issuesofChineseJournalofRadiologywereconsultedbyclinicalexpertstrained byChineseCochraneCenter,therelativerandomizedcontrolledtrial (RCT)andcontrolledclinicaltests (CCT) articleswereconsultedonebyonemanually .Results Withincreasingyears,thepercentageofRCTandCCT articlesaccountingforallclinicalexperimentalarticleswasincreasinggradually .BothRCTandCCTwere 0 %at early 80thandincreasedto 2 .17%and 7.97%respectivelyattheendof90th .Conclusion Theinvestigation levelofclinicalinterventionaltreatmentexperimentalarticlesisimprovinggradually ,butthepercentageofRCTand CCT :Forclinicaltreatmentexperimentalarticlesisstillnothighenough ,thedesign ,implementationandanalysis ofRCTarenotstandardizedsothatproblemsstillexistintermsofconfidenceofresult.

Objective To explore the in vitro antibacterial effect of tanreqing injection combined with cefuroxime sodium injection against staphylococcus aureus. Methods The MIC of tanreqing injection or cefuroxime sodium injection against staphylococcus aureus was detected by microamount dilution method.The antibacterial activity of tanreqing injection combined with cefuroxime sodium injection was determined by a chess board dilution method and assessed according to FIC index. Results The MIC of tanreqing injection and cefuroxime sodium injection against staphylococcus aureus was 1∶256 and 2 μg . mL-1 , respectively. While combined with each other, the MIC of tanreqing injection and cefuroxime sodium injection against staphylococcus aureus was 1∶4 096 and 0. 125 μg . mL-1 , respectively. The FIC index of tanreqing injection combined with cefuroxime sodium injection against staphylococcus aureus was 0. 125. Conclusion Tanreqing injection has a synergistic antibacterial effect against staphylococcus aureus when it was combined with cefuroxime sodium injection.

Objective To analyze the effects of individualized lifestyle intervention on compliance and metabolic status of patients with type 2 diabetes mellitus (T2DM).Methods Two hundred T2DM patients were selected and randomly divided into experimental and control groups of 100 patients respectively.The experimental group was given individualized lifestyle intervention for 6 months in addition to conventional oral medications.The intervention was to prescribe diet control and exercise therapy according to the patients' individual conditions.The control group was given conventional treatment and verbal lifestyle intervention for 6 months.Comparison was made in patients compliance and various metabolic markers between the two groups.Results The percentage of conduction of diet control and exercise therapy in experimental group was significantly higher than control group ( Diet control:80 vs.52,x2=7.08,P=0.029;Exercise therapy:78 vs.44,x2=11.207,P=0.004).After intervention,the fasting plasma glucose (FPG),2-hour postprandial blood glucose (2hPG),glycated hemoglobin ( HbA1c),body mass index ( BMI),triglyceride ( TG),total cholesterol (TC),low-density lipoprotein ( LDL-C ),and insulin resistance index ( HOMA-IR ) in experimental group decreased significantly,and high-density lipoprotein ( HDL-C ) increased significantly [FPG:( 8.45 ± 1.46 ) mmol/L vs.(6.66 ± 0.67) mmol/L,P=0.000;2hPG:( 12.76 ± 2.25 ) mmol/L vs.(8.22 ± 1.79) mmol/L,P=0.000;HbA1c:(7.68 ± 1.06 ) ％ vs.( 6.48 ± 0.69 ) ％,P=0.000;BMI:( 25.90 ± 1.72 ) kg/m2 vs.( 22.81 ±1.41 ) kg/m2,P=0.016;TG:(2.57 ±0.68) mmol/Lvs.( 1.88 ±0.35) mmol/L,P=0.006;TC:(5.72 ±0.13) mmol/L vs.(5.14 ± 1.38) mmol/L,P=0.043;LDL-C:(3.28 ±0.10)mmol/L vs.(2.81 ±0.57)mmol/L,P=0.009;HOMA-IR:7.58 ± 0.19 vs.4.58 ± 1.98,P=0.000;HDL-C:( 1.29 ± 0.04) mmol/L vs.( 1.62 ± 0.27 ) mmol/L,P=0.003].The levels of FPG,2hPG,HbA1c,BMI,TG,HOMA-IR also decreased in control group after intervention compared with before intervention [FPG:( 8.67 ± 2.71 ) mmol/L vs.( 7.26 ± 1.21 ) mmol/L,P=0.001;2hPG:( 12.82 ± 2.15 ) mmol/L vs.( 10.85 ± 1.98 ) mmol/L,P=0.000,HbA1c:( 7.75 ± 1.08 ) ％ vs.( 7.01 ± 0.87 ) ％,P=0.002;BMI:( 25.82 ± 1.74 ) kg/m2 vs.( 24.23 ± 1.36 ) kg/m2,P=0.024;TG:(2.47 ±0.75) mmol/L vs.(2.13 ± 0.43 ) mmol/L,P=0.018;HoMA-IR:7.88 ± 0.20 vs.6.15 ± 2.01,P=0.042].No significant difference was found on the values of TC,HDL-C and LDL-C before and after intervention in control group (P ＞ 0.05).The effect of intervention of experimental group was more obvious when compared with control group ( FPG:P=0.036;2hPG:P=0.000;HbA1c:P=0.045;BMI:P=0.037;TG:P=0.022;HoMA-IR:P=0.000).Conclusion Individualized lifestyle intervention can improve the compliance of T2DM patients,and was in favor of control metabolic status of T2DM patients to delay the occurrence and development of complications.

Objective To explore a quick and feasible method of screening malaria parasite by using a Sysmex XE-2100 hematology analyzer though alarm information on high eosinophil count and atypical eosinophil distributions in the WBC scattergram. Methods Sysmex XE-2100 hematology analyzer was used for complete blood cell analysis. Microscopic review was used when high eosinophil count and atypicaleosinophil distributions in the WBC scattergram were found. If the review showed normal eosinophil cells, wecontinued to focus on red cell for searching malaria parasite. Results Among 1 501 specimens showing higheosinophil counts and atypical eosinophil distributions, nine cases with normal eosinophil cells were indisaccordance with the hematology analyzer, six of them showed high eosinophil count in the Sysmex XE-2100 hematology analyzer, whose distribution was located close to neutrophil clusters in scattergram. The otherthree had an abnormal WBC scattergram. There was no gap between eosinophil clusters and neutrophilclusters, which brought no classified results. But all the nine specimens had been found the trophozoite,schizont and merozoite in blood smears. Conclusions There were great possibility of the existence of themalaria parasite in specimens when hematology analysis showed high eosinophil count and atypical eosinophildistributions in the WBC scattergram in a Sysmex XE-2100 hematology analyzer, although these alarm wasnot comfirmed by microscopic review. This method provides not only a simple and reliable way for quickscreening malaria parasite but also has a great value in preventing the undetected ratio on malaria parasite.

Objective:To investigate the effects of laparoscopy assisted complete mesocolon resection on the stress response and immune function of patients with colon cancer.Methods:From January 2013 to January 2016,130 patients with colon cancer in our hospital were selected and randomly divided into the observation group and the control group with 65 cases in each group according to the random lottery envelopes.The observation group was treated with laparoscopy assisted complete mesocolon resection,the control group was treated with open operation.The changes of semm IL-6,TNF-α and amours of CD4+ cells,blood loss,bowel function restoration time,hospital stays and complication rate of two groups were compared before and after treatment.Results:Both groups of patients were successfully completed the surgery and there was no serious complications occurred in both groups.The amount of bleeding,postoperative intestinal recovery time and postoperative hospital stay in the observation group were significantly less than those of the control group (P＜0.05).The chylous fistula,wound infection,pulmonary infection and complication rate on the 14th day postoperation in the observation group was 1.5％,which was 12.3％ in the control group and significantly higher than that of the control group (P＜0.05).The contents ofCD4+ cells in the observation group and the control group were 36.34± 7.83％ and 33.66± 9.82％,respectively,which were significantly higher than those before treatment(30.33± 6.49％ and 30.49± 5.33％)(P＜0.05),and the contents of CD4+ cells of observation group was significantly higher than that of the control group after treatment (P＜0.05).The serum levels ofIL-6 and TNF-α in both groups were significantly lower than those before treatment on the 14th day postoperation (P＜0.05),and the serum IL-6 and TNF-α levels of observation group were significantly lower than those in the control group on the 14th day postoperation (P＜0.05).Conclusion:Laparoscopy assisted complete mesocolon resection could promote the immune function and inhibit the stress response,which further promoted the rehabilitation and induced the complications in the treatment of patients with colon cancer.

Three-orientation medical talent training mainly include humanistic quality cultivation, professional quality and physical and mental quality. With professional ability as the guidance of profes-sional quality education requires students not only to grasp skilled medical technology, but also have the ability to enhance the medical technology. Based on the orientation of training target, this research mainly from habit set, authority set, set the multitude and empirical mind-set four aspects in this paper, the critical thinking, and put forward problems from finding problems, and expounds the innovative thinking of concise problem.

Objective To investigate the effects of low temperature adjustable sodium dialysis combined Astragalus injection in patients with chronic cardiac insufficiency uremia combined the clinical curative effect of dialysis related hypotension .Methods Fourty‐nine patients with uremia combined chronic cardiac insufficiency and suffered repeated dialysis hypotension were involved in this study ,and they were divided into treatment group(n=25) and control group(n=24) .Patients in the control group were treated with hemodialysis for low temperature (35 .5 ℃) ,and sodium curve dialysis ;patients in the treatment group were treated with the same method in that of control group ,and they were treated with astragalus injection 40 mL continuous intravenous drip .Then ob‐serve the blood pressure changes and treatment effect of the two groups of before and after treatment .Results Systolic pressure of the treatment group and the control group was (92 .6 ± 8 .4) and (89 .5 ± 9 .0) mm Hg ,and that of after treatment was (99 .9 ± 8 .0) and (94 .9 ± 9 .3) mm Hg respectively ,the difference before and after treatment in each group was significant (t=3 .147 , 2 .044 ,P<0 .05) ,and the difference of systolic pressure before and after treatment in each group was significant (t=2 .020 ,P<0 .05) .Before the treatment ,the left ventricular ejection fraction score of treatment group and control group was (45 .80 ± 3 .62)%and (46 .01 ± 3 .59)% ,and that of after treatment was (59 .05 ± 3 .15)% and (53 .85 ± 1 .60)% ,respectively ,and the difference be‐fore and after treatment was significant (t=13 .906 ,9 .847 ,P<0 .05) ,and the difference of the left ventricular ejection fraction score after treatment in the two groups was significant (t=7 .328 ,P<0 .05) .Conclusion For patients with uremia combined chronic car‐diac insufficiency and suffered repeated dialysis hypotension ,low temperature adjustable sodium dialysis can significantly reduce the incidence of hypotension in the process of dialysis .But combined huangqi injection in the treatment group could significantly in‐creased the left ventricular ejection fraction ,thus improve the left ventricular function in patients with dialysis .

Objective To investigate the survival benefit of patients with esophageal squamous cell carcinomas who recieved postoperative chemotherapy of tegafur combined with FT-207 radiotherapy.Methods Data from 126 patients with esophageal squamous were analyzed who undergone radical resection from January 2008 to December 2010,consisting of 92 patients underwent surgery alone and 34 patients took oxaliplatin combined with tegafur postoperatively (oxaliplatin 130 g/m2,d1,tegafur 500 mg/m2,d1-5,21 d for a cycle,every patient received at least two cycles).Results The 1-year survival rate and 3-year survival rate was 93.5 ％ and 75.0 ％ in the surgery alone group,was 97.1％ and 76.2 ％ in the surgery plus postoperative chemotherapy (P =0.590).There was no significant differences in survival in the two groups,even with Coxregression multivariate analysis and with stratifications of gender,age,tumor location,degree of cell differentiation,invasion depth,lymphatic metastasis and TNM stage.Conclusion Postoperative adjuvant chemotherapy with oxaliplatin combined with tegafur has not significantly improve the survival rate of patients with esophageal squamous cell carcinomas undergoing radical resection.It is still lack of an effective project for postoperative adjuvant chemotherapy for esophageal cancer,and it is necessary for further study.

With the extensive application of informationalized management systems for barcode specimens , the degree of informatization is becoming higher and higher in medical laboratory.Informationalized management combines modern information technology and advanced management concepts , transforms or reengineers the laboratory operation and business process.Test specimen turnaround time ( TAT) is an important factor affecting the quality of the inspection.By analyzing the test process of each time node , establish the suitable specimens monitoring program for clinical requirements and real -time monitor the key nodes in test processes ,which will effectively shorten TAT , improve reporting timeliness rate and avoid clinical complaints.